Dental Providers
New Effective January 1, 2008 HRSA pays certified primary care medical providers for delivering topical fluoride application, family oral health education, and periodic oral evaluations. Non-certified primary care medical providers will only receive reimbursement for fluoride application. Training and certification will be provided by Washington Dental Service Foundation. 08-03 Medicaid Billing and Contact Information for Primary Care Medical Providers Delivering Dental Disease Prevention Services
New February 21, 2008 Numbered Memos
08-04 Updates to the Fee Schedule and Prior Authorization
Clarification: Anterior crowns for ages 12-20 only
Posterior crowns ages 18-20 only
Four bite-wing x-ray's required with multiple crown requests
Clarification: D3320 and D3330 for adults do not require prior authorization after 11-30-07.
The Department does not cover endodontic services for
third molars (teeth #1, 16, 17, 32).
New On July 1, 2008, HRSA will require the most current ADA claim form (2006) for billing. Claims submitted on non-ADA claim forms will be returned to provider. HRSA encourages providers to bill electronically for the most efficient distribution of payment (see billing instructions).
August 1, 2007 Numbered Memo. Fee Schedule, Anesthesia Billing, Prior Authorization, and Coverage Changes.
Dental program rules are effective April 1, 2007. (see billing instructions below)
Billing Instructions are now available.
Fee Schedule effective January 1, 2008
Fee Schedule effective August 1, 2007
New Prior authorization form 13-788 required for removable prosthetics for those clients who reside in nursing homes, hospices, or other institutions. Find it under Common Forms on the left of the page.
New radiographic data warehouse services available through National Electronic Attachment Inc. (NEA) for information call 1-800-782-5150, ext. 2. See NEA Provider FAX.
The purpose of the Dental Program is to reimburse for quality dental
and dental-related services to eligible clients.
Use the links at the top for information specific to our dental
providers. Use the links to the left for general medical assistance
provider billing information.
We want to hear from you! Let us know what you would like to see on
our dental Web site. Email us at contact us with your suggestions
and thoughts.
Our staff provides on-site or in-house provider training on billing
and claims issues. Use this link to
contact us.
For comments or questions, email contact us